Hughes Dawn S, Magann Everett F
Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Best Pract Res Clin Obstet Gynaecol. 2017 Jan;38:12-23. doi: 10.1016/j.bpobgyn.2016.08.004. Epub 2016 Sep 16.
The evaluation of amniotic fluid volume (AFV) is an established part of the antenatal surveillance of pregnancies at risk for an adverse pregnancy outcome. The two most commonly used ultrasound techniques to estimate AFV are the amniotic fluid index (AFI) and the single deepest pocket (SDP). Four studies have defined normal AFVs, and although their normal volumes have similarities, there are also differences primarily due to the statistical methodology used in each study. Dye-determined AFV correlates with ultrasound estimates for normal fluid volumes but correlates poorly for oligohydramnios and polyhydramnios. The addition of color Doppler in estimating AFV leads to the overdiagnosis of oligohydramnios. Neither the AFI nor the SDP is superior in identifying oligohydramnios, but the SDP is a better measurement choice as the use of AFI increases the diagnosis rate of oligohydramnios and labor inductions without an improvement in pregnancy outcomes.
羊水体积(AFV)评估是对有不良妊娠结局风险的妊娠进行产前监测的既定组成部分。两种最常用的超声技术来估计AFV是羊水指数(AFI)和最大羊水深度(SDP)。四项研究定义了正常的AFV,尽管它们的正常体积有相似之处,但也存在差异,主要是由于每项研究中使用的统计方法不同。染料测定的AFV与正常液体体积的超声估计值相关,但与羊水过少和羊水过多的相关性较差。在估计AFV时添加彩色多普勒会导致羊水过少的过度诊断。AFI和SDP在识别羊水过少方面都不具有优势,但SDP是更好的测量选择,因为使用AFI会增加羊水过少的诊断率和引产率,而不会改善妊娠结局。